- The rapid control of hypertension during cardiac surgery
- Reducing blood pressure and maintain controlled hypotension during surgical procedures
- Controlling myocardial ischemia during and after surgery
- Unresponsive congestive heart failure secondary to acute myocardial infarction
- Unstable angina which is refractory to treatment with beta blockers and sublingual nitrates
Glyceryl Trinitrate 1 mg
18 Years Old and Above
The dose of glyceryl trinitrate should be adjusted to meet the individual needs of the patient and the responses of the monitored hemodynamic parameters. The recommended dosage range is 10-200 μg/minute but up to 400 μg/minute may be necessary during some surgical procedures.
Glyceryl trinitrate solution is a concentrate which should be diluted prior to IV administration. The product is normally administered IV as an admixture using a suitable vehicle such as 5% dextrose or 0.9% sodium chloride injection.
Glyceryl trinitrate is incompatible with polyvinylchloride (PVC) and severe loses of glyceryl trinitrate (over 40%) may occur if this material is used. Contact with PVC bags should be avoided.
A starting dose of 25 μg/minute is recommended for the control of hypertension, or to produce hypotension during surgery. This may be increased by increments of 25 μg/minute at 5-minute intervals until the blood pressure is stabilized. Doses between 10-200 μg are usually sufficient during surgery, although doses of up to 400 μg/minute have been required in some cases.
The treatment of perioperative myocardial ischemia may be started with a dose of 15-20 μg/minute with subsequent increments of 10-15 μg/minute until the required effect is obtained.
Unresponsive Congestive Heart Failure
The recommended starting dose is 20-25 μg/minute. This may be decreased to 10 μg/minute or increased in steps of 20-25 μg/minute every 15-30 minutes until the desired effect is obtained.
An initial dose of 10 μg/minute is recommended, with increments of 10 μg/minute being made at approximately 30 minute intervals according to the needs of the patient.